DESCRIPTION (Investigator's Abstract): This research is focused around the Patient Self Determination Act which provides that written information about the patients' legal options for advance directives must be given to adults upon admission to a hospital, nursing home, hospice, or prior to the delivery of home health care services. Failure to provide this written information and to comply with the requirements may result in a loss of payment to the health care institution by Medicare and Medicaid (Public Law 101-508). The objective of this project is to develop and pilot-test instruments to assess the patient's knowledge and use of a living will and durable power of attorney for health care. The study will develop a record review form and a telephone interview instrument, which will be field-tested on a probability sample of 500 patients admitted to six Iowa hospitals of varying sizes and types. The specific aims are to: 1) develop an interview schedule that assesses patients' knowledge of their legal options for health care decisions; 2) interview a probability sample of patients from six hospitals of various sizes, using the interview schedule; 3) develop a record review form for determining if patients' preferences and decisions regarding legal options have been documented in their hospital record; and 4) abstract hospital records of the patients sampled for interviews, using the newly developed review form. To contain costs while still accessing a variety of settings and patient populations, patients will be sampled from six hospitals located within 60 miles of Iowa City. These include one hospital with over 700 beds, two 400-700 bed hospitals, two with 200-400 beds, and one with fewer than 200 beds. At each of the six hospitals, the staff member responsible for informing patients of their options will assist in recruiting patients for this research. The investigator or an assistant will be assigned to each hospital to obtain informed consent for the research.